Basic Information
| Provider Information | |||||||||
| NPI: | 1831109024 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JEAN-PIERRE | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 HIGHLAND PKWY | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PICAYUNE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394665577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6017985798 | ||||||||
| FaxNumber: | 6017983964 | ||||||||
| Practice Location | |||||||||
| Address1: | 128 HIGHLAND PKWY | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PICAYUNE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394665577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6017985798 | ||||||||
| FaxNumber: | 6017983964 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 12/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 19428 | MS | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 03428890 | 05 | MS | MEDICAID | 1050717 | 05 | LA | MEDICAID | P00634449 | 01 | MS | RAILROAD MEDICARE | OTHER |